The specific aims of the proposed research are to study the effects of 2 carefully documented levels of early mental health service intervention on the outcome for high risk infants from high risk family backgrounds. Specifically, the less than 32 week premature infant is known to be at increased risk for future development in terms of social-emotional, cognitive and motoric functioning. Parents from the economically stressed lower 2 classes by Hollingshead criteria are known to be at high risk for parenting suchan infant, since the provision of individualized care is typically sparsest for them and since the compounding of socioeconomic stress with the task of parenting a very vulnerable, fragile infant places such an infant and family in great jeopardy for later outcome. We seek to show an impact on the outcome of the infants at 1 and 2 years of age in terms of mental health, social-emotional, cognitive and motoric functioning and on the mental health psychodynamic functioning of the parents in terms of initiative and control in utilizing resources and in terms of parenting and self-image. Two levels of mental health service intervention will be tested: 1) sharing repeated behavioral evaluations of the infant with the parents; 2) sharing repeated behavioral evaluations of the infant with the parents and in addition triaging mothers on the basis of psychiatric evaluations for more specific early mental health support and triaging babies early for intervention programs on the basis of the behavioral and neurological assessments. Random assignment of 150 infants to a control group and the 2 intervention study groups will permit testing of relative efficacy of the interventions. The cost-effectiveness of each level of intervention will also be measured. Disciplines involved in the conduct of the project include psychiatry, clinical psychology, developmental pediatrics, neonatology, developmental psychology, early childhood education, and pediatric and psychiatric nursing. A well-documented model of cost-effective, preventive and ameliorative mental health care for high risk infants in economically stressed environments is the long term product.